Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data

Abstract

Microbeam radiotherapy (MRT) is a novel, still preclinical dose delivery technique. MRT has shown reduced normal tissue effects at equal tumor control rates compared to conventional radiotherapy. Treatment planning studies are required to permit clinical application. The aim of this study was to establish a dose comparison between MRT and conventional radiotherapy and to identify suitable clinical scenarios for future applications of MRT. We simulated MRT treatment scenarios for clinical patient data using an inhouse developed planning algorithm based on a hybrid Monte Carlo dose calculation and implemented the concept of equivalent uniform dose (EUD) for MRT dose evaluation. The investigated clinical scenarios comprised fractionated radiotherapy of a glioblastoma resection cavity, a lung stereotactic body radiotherapy (SBRT), palliative bone metastasis irradiation, brain metastasis radiosurgery and hypofractionated breast cancer radiotherapy. Clinically acceptable treatment plans were achieved for most analyzed parameters. Lung SBRT seemed the most challenging treatment scenario. Major limitations comprised treatment plan optimization and dose calculation considering the tissue microstructure. This study presents an important step of the development towards clinical MRT. For clinical treatment scenarios using a sophisticated dose comparison concept based on EUD and EQD2, we demonstrated the capability of MRT to achieve clinically acceptable dose distributions.

DoseMRT: A Software Package for Individualised Monte Carlo Dose Calculations of Synchrotron-Generated Microbeam Radiation Therapy

“…Due to the steep dose gradients on a micrometer scale and relatively low beam energy, no commercial treatment planning system (TPS) is suitable for MRT dose calculations without additional modification. Some research groups have successfully implemented customised dose calculation engines into commercial treatment planning systems, such as Eclipse (v11.0.31) [4][5][6], VIRTUOS [7], and 3DSlicer [8]. Other groups have used the PENE-LOPE Monte Carlo code system to develop dose engines in the absence of a commercial TPS [9,10].…”